Alison Kerns

During my role I medically manage short term disability claims for Amazons in house disability and leave services department. Within this role I worked directly with all parties associated with the case. The types of cases range from employee own health conditions, pregnancy, paid parental leave, and etc. Daily reviews over qualifications based on the HR feed and also the medical documents received in order to distribute benefits out. With coordination with the state statutory plans we run the case concurrently for the employees to help streamline the process of leave. In this role the use of various HR systems is done everyday in order to processing management. In this roll I am currently managing 200+ cases.

During my role a statutory claims specialist I worked with one particular client with their state leave policies for their employees while they were out on leave, whether it be short term or long-term disability for the duration of time we would work in coordination with their third-party administrator Sedgwick as the case would work concurrently together for the client’s employees. Doing so we would assess the employee’s medical documents to ensure they would qualify for state benefits during their duration of their leave deeming it medically necessary for them to be out due to employees unable to perform job functions.

During this role mange short term disability claims for the maternity for our client. In this role cases would run concurrently with statutory state which involved communications with outside parties. Using information from the state and medical documents we would determine eligibility for paid benefits. During this time, we want to ensure that the individual’s time off work runs smooth and they are receiving benefits within our guidelines. We remain in contact with all the parties in the claim. With coordination with our trainers and other supervisors I would also assist frequently with new hire trainings. Additionally, I would work with our direct supervisor during their absence or in office to assist with managing the other representatives in our everyday work duties. Some of these additional duties would involve initiating training for new hires or current colleagues in regards to changes or the current process.

During this role I mange short term disability claims for the maternity team. On this team we process claims with medical to support or no medical to support the individuals time off work. During this we want to ensure that the individual’s time off work runs smooth and they are receiving their benefits while under a concurrent leave. During this time, we want to ensure that the individual’s time off work runs smooth and they are receiving benefits within our guidelines. We remain in contact with all the parties in the claim.

During this role I medically managed BWC claims by facilitating with the parties of the claim, which are the injured worker, employer, providers, and BWC. We want to make sure that the injured worker is getting the medical treatment that is necessary to help heal them from the work-related injury, to make sure we do our best with our resources to get the injured worker back to work, and to make sure that all parties to the claim are aware of the actions that are going on with the claim. Some of the additional responsibilities would include assisting them with the transition to vocational services through out TPA and in some more complex cases we would need to team up with our nurses on the team to review over documentation.

I held administrative responsibilities, such as taking phone calls, billing, scheduling, greeting patients, treating patients with prescribed therapies, charting patient information, and maintaining inventory. Developed the skill of processing and developing X-rays. Strengthened my knowledge of health insurance companies. Collaborated with the Doctor with therapeutic ideas for patients and with office flow. In addition, I would assist with the paper work for disability, workers compensation, and VA when needed for patients.

I traveled as an Administrative Assistant to various clinics, performing administrative duties, such as collecting patient’s information, verifying insurances, managing patient flow, and assisting nurses. I work with little supervision at clinics; I would operate independently at most clinics.